RT Journal Article
T1 Influence of Tunneled Hemodialysis-Catheters on Inflammation and Mortality in Dialyzed Patients.
A1 Crespo-Montero, Rodolfo
A1 Gomez-Lopez, Victoria E
A1 Guerrero-Pavon, Fatima
A1 Carmona-Muñoz, Andres
A1 Romero-Saldaña, Manuel
A1 Ranchal-Sanchez, Antonio
A1 Aljama-Garcia, Pedro
K1 Central venous catheter
K1 Fistula
K1 Hemodialysis
K1 Inflammatory status
K1 Mortality
AB Older age and comorbidities in hemodialysis patients determines the use of tunneled catheters as vascular access despite their reported clinical and mortality disadvantages. This prospective matched study analyzes the impact of permanent catheters on inflammation and mortality in hemodialysis patients; We studied 108 patients, 54 with AV-fistula (AVF) and 54 with indwelling hemodialysis catheters (HDC) matched by sex, age, diabetes and time under renal-replacement therapy comparing dialysis efficacy, inflammation and micro-inflammation parameters as well as mortality. Cox-regression analysis was applied to determine predictors of mortality, HDC patients presented higher C-reactive-protein (CRP) blood levels and percentage of pro-inflammatory lymphocytes CD14+/CD16+ with worse dialysis-efficacy parameters. Thirty-six-months mortality appeared higher in the HDC group although statistical significance was not reached. Age with a Hazard Ratio (HR) = 1.06, hypoalbuminemia (HR = 0.43), hypophosphatemia (HR = 0.75) and the increase in CD14+/CD16+ monocyte count (HR = 1.02) were predictors of mortality; elder patients dialyzing through HDC show increased inflammation parameters as compared with nAVF bearing patients, although they do not present a significant increase in mortality when matched by covariates. Increasing age and percentage of pro-inflammatory monocytes as well as decreased phosphate and serum-albumin were predictors of mortality and indicate the main conclusions or interpretations.
PB MDPI
YR 2021
FD 2021-07-14
LK http://hdl.handle.net/10668/18248
UL http://hdl.handle.net/10668/18248
LA en
NO Crespo-Montero R, Gómez-López VE, Guerrero-Pavón F, Carmona-Muñoz A, Romero-Saldaña M, Ranchal-Sanchez A, et al. Influence of Tunneled Hemodialysis-Catheters on Inflammation and Mortality in Dialyzed Patients. Int J Environ Res Public Health. 2021 Jul 16;18(14):7605
DS RISalud
RD Apr 7, 2025